title: Open versus thoracoscopic esophagectomy in patients with esophageal squamous cell carcinoma.
abstract: BACKGROUND
  The impact of minimally invasive esophagectomy on patient prognosis, particularly disease-free survival (DFS), has not been well addressed. We compared the clinical outcomes of open and thoracoscopic esophagectomy in patients with esophageal squamous cell carcinoma (ESCC).
  
  
  METHODS
  Sixty-three and 66 patients, nonrandomized, underwent open and thoracoscopic esophagectomies for ESCC between 2008 and 2011 were included. The clinicopathological data were reviewed retrospectively. Perioperative outcome, overall survival (OS), DFS, and the recurrence sites after open and thoracoscopic esophagectomy were compared.
  
  
  RESULTS
  The open and thoracoscopic groups were comparable with regard to the total number of harvested lymph nodes and the percentage patients undergoing R0 resection. Fewer patients in the thoracoscopic group had pneumonia and wound complications. Intensive care unit (ICU) stay also was shorter in the thoracoscopic group. The recurrence pattern was similar in the two groups. In the open and thoracoscopic groups, the 3-year OS rates were 47.6 and 70.9 % (p = 0.031), respectively, and the 3-year DFS rates were 35 and 62.4 % (p = 0.007), respectively. However, the trends in better OS and DFS in the thoracoscopic group were not significant after stratification according to pathologic stage.
  
  
  CONCLUSIONS
  The perioperative benefit of thoracoscopic esophagectomy included fewer postoperative complications and shorter ICU stays. Mid-term OS and DFS associated with thoracoscopic techniques are at least equivalent to those associated with open procedures.
authors.affiliation: Division of Thoracic Surgery, Department of Surgery, Taipei-Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road, Taipei, Taiwan, hsupokuei@yahoo.com.tw.
authors.forename: Po-Kuei
authors.initials: PK
authors.lastname: Hsu
authors.forename: Chien-Sheng
authors.initials: CS
authors.lastname: Huang
authors.forename: Yu-Chung
authors.initials: YC
authors.lastname: Wu
authors.forename: Teh-Ying
authors.initials: TY
authors.lastname: Chou
authors.forename: Wen-Hu
authors.initials: WH
authors.lastname: Hsu
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D018572:Disease-Free Survival; D004938:Esophageal Neoplasms / Q000601:surgery*; D016629:Esophagectomy / Q000379:methods*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D013906:Thoracoscopy / Q000379:methods; D016896:Treatment Outcome